Activities of Daily Living Are Improved by Inpatient Multimodal Complex Treatment for PD—a Real‐World Cohort Study

BACKGROUND: The multimodal complex treatment for Parkinson's disease (MCT) provides inpatient care by a multi‐disciplinary team for people with Parkinson's disease (PwP) in Germany. OBJECTIVES: We conducted a 5‐year real‐world mono‐center cohort study to describe the effectiveness of MCT in the full cohort and various subgroups and outcome predictors. METHODS: We collected an anonymized dataset between Jan 2015 and Dec 2019, involving N = 1773. The self‐reported MDS‐UPDRS part II was used as primary outcome, and clinical routine data for explanatory variables. PwP were categorized as responders or non‐responders according to a response of at least 3 points 4 weeks after discharge. RESULTS: N = 591 complete data records were available for statistical analyses. The full group improved by −2.4 points on the MDS‐UPDRS II (P = <0.0001). 47.7% (n = 282) and 52.3% (n = 309) were coded as responders and non‐responders, respectively. A clinically meaningful response was positively associated to age (χ(2) = 11.07, P = 0.018), as well as baseline‐severity of the MDS‐UPDRS II (χ(2) = 6.05, P = 0.048) and negatively associated to the presence of psychiatric disorder (χ(2) = 3.9, P = 0.048) and cognitive dysfunction (χ(2) = 7.29, P = 0.007). Logistic regression showed that baseline severity of the MDS‐UPDRS II predicted therapy success. PwP with moderate baseline‐severity had an about 2fold chance (OR 2.08; 95% CI 1.20–3.61; P = 0.009) and with severe an about 6fold chance (OR 5.92; 95% CI 2.76–12.68; P < 0.0001) to benefit clinically meaningful. DISCUSSION: In a naturalistic setting of a specialized Parkinson's center, MCT improved ADL disability of PwP at least 4 weeks after discharge. Moderately and severely impaired patients were more likely to achieve clinically meaningful responses.